Deep dive on big catch-up monitoring in Mozambique
Mozambique has made impressive strides in childhood immunization, as confirmed by the latest IA2030 zero-dose country rankings. The country, which ranked 12th in 2021, achieved a milestone by dropping out of the top 20 countries with unvaccinated children as of 2023. This progress highlights Mozambique's effective response to The Big Catch-Up (BCU), a global initiative launched in April 2023 to address immunization gaps left by the COVID-19 pandemic.
The BCU initiative provides a framework for countries to regain momentum in immunization coverage and mandates rigorous guidelines and reporting standards to monitor progress. Mozambique’s team shared their experiences and insights on implementing BCU during a global call held on September 30, 2024, discussing both their achievements and ongoing challenges. As countries move from the planning phase to implementing BCU initiatives, sharing progress and lessons learned has become vital to shaping global efforts.
Mozambique’s achievements are rooted in a multipronged, data-driven approach. Using their national DHIS2 data system, healthcare teams track vaccination records and categorize missed children at local levels, feeding information into strategic planning efforts at the national level. This system is supplemented by Geographic Information System (GIS) mapping, tested in high-priority regions such as Nampula Province, where vaccination gaps have been most pronounced. Through these efforts, over 876,000 missed children were identified, particularly in Nampula and Zambezia. Following three waves of targeted catch-up campaigns known as the Periodic Intensification of Routine Immunization (PIRI), the team vaccinated around 524,000 children, achieving 69% coverage of this target population.
Despite substantial progress, Mozambique’s BCU efforts have faced challenges, including delayed monitoring guidelines, lagged data submissions, and the logistical demands of reaching remote communities. A notable hurdle is the ongoing need to reclassify children’s immunization status accurately, which is crucial to target resources effectively during each PIRI campaign. Moving forward, Mozambique plans to integrate GIS mapping further into its community-based vaccination efforts with support from the UPSCALE Project, aiming to strengthen the Expanded Program on Immunization (EPI) and deepen their understanding of missed children.
Survey data from 16 high-priority districts have underscored the social dynamics behind improved vaccination rates. Positive perceptions of vaccine safety, higher parental education levels, women’s roles in household incomes, and younger parental age all correlate with better immunization outcomes. Mozambique’s EPI team plans to incorporate these findings into future campaigns to close remaining immunization gaps.
Mozambique’s journey offers a proactive model for nations addressing zero-dose challenges and demonstrates how real-time data, community engagement, and targeted interventions can support a healthier future for children, aligning closely with the global goals of The Big Catch-Up initiative.
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Compilation: Ekokobe Elias Forbin | UNICEF Eastern and Southern Africa Regional Office (ESARO)
Photo credit: WHO